Are Prophylactic Systemic Antibiotics Required in Patients with Cataract Surgery at Local Anesthesia?
Are Prophylactic Systemic Antibiotics Required in Patients with Cataract Surgery at Local Anesthesia?
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DOI：
10.3390/ijerph192315796
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发表时间：
2022-11-27
影响因子：
--
通讯作者：
Hagiya, Hideharu
中科院分区：
文献类型：
--
作者：
Matsuo, Toshihiko;Iguchi, Masahiro;Morisato, Noriyasu;Murasako, Tatsuya;Hagiya, Hideharu
关键词：
根据世界卫生组织2015年发布的抗微生物药物耐药性全球行动，世界各地都建议减少使用抗微生物药物。在这项研究中，我们回顾性地回顾了在一家医院连续接受白内障手术的患者，在逐步减少预防性全身抗生素的6年过程中手术部位感染的发生率。根据全身性抗生素的使用情况，将2016年至2022年的整个研究期分为五个阶段。在一期649例白内障手术中，手术时静脉滴注头孢唑林1 g，手术当天晚上口服头孢地尼100 mg，术后2天口服三次。在第二期541例白内障手术中，术前早晚口服头孢地尼100毫克，术后两天口服三次（共300毫克）。在第三阶段103例白内障手术中，术前晚些时候口服左氧氟沙星500 mg，术后两天每天早上口服一次。在第4期545例白内障手术中，仅在手术前晚些时候口服左氧氟沙星500 mg。在第5期311例白内障手术中，没有给予全身抗生素。莫西沙星滴眼液在术前3天和术后约2周内作为局部抗生素，每天4次，作为所有阶段的常规程序。手术时，经常用0.5%工作浓度的盐水稀释聚维酮碘冲洗眼表。术后各阶段均无感染记录。本研究表明，减少使用预防性全身抗生素既无危害也无风险，因此，只要采取了局部预防措施，白内障手术中就不会使用预防性全身抗生素。
The reduced use of antimicrobial drugs has been recommended worldwide, according to the global action for antimicrobial resistance published in 2015 by the World Health Organization. In this study, we retrospectively reviewed the incidence of surgical site infection in consecutive patients with cataract surgeries at a single hospital in the 6-year process when prophylactic systemic antibiotics were reduced in a step-by-step manner. The entire study period from 2016 to 2022 was divided into five stages, based on the use of systemic antibiotics. In stage 1 with 649 cataract surgeries, an intravenous drip infusion of cefazolin 1 g was given at surgery, followed by oral cefdinir 100 mg in the evening on surgery day and three times for two postoperative days. In stage 2 with 541 cataract surgeries, oral cefdinir 100 mg was given in the late morning before surgery, in the evening, and three times (300 mg in total) for two postoperative days. In stage 3 with 103 cataract surgeries, oral levofloxacin 500 mg was given in the late morning before surgery and once in the morning for two postoperative days. In stage 4 with 545 cataract surgeries, oral levofloxacin 500 mg was given only in the late morning before surgery. In stage 5 with 311 cataract surgeries, no systemic antibiotics were given. As common procedures in all stages, moxifloxacin eye drops were given four times daily as topical antibiotics in the 3 days before surgery and about 2 weeks after surgery. At surgery, the ocular surface was frequently irrigated with saline-diluted povidone iodine at 0.5% working concentration. No postoperative infection was recorded in any stage. This study showed neither harm nor risk in reduced use and, consequently, no use of prophylactic systemic antibiotics in cataract surgery as far as local precautionary measures were secured.
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影响因子：
4.1
作者：
Alster, Y;Herlin, L;Loewenstein, A
通讯作者：
Loewenstein, A
DOI：
10.1002/14651858.cd006364.pub3
发表时间：
2017-02-13
期刊：
The Cochrane database of systematic reviews
影响因子：
--
作者：
Gower EW;Lindsley K;Tulenko SE;Nanji AA;Leyngold I;McDonnell PJ
通讯作者：
McDonnell PJ
影响因子：
2
作者：
Kawata T;Matsuo T
通讯作者：
Matsuo T
影响因子：
4.2
作者：
Shimada, Hiroyuki;Arai, Shinzi;Yuzawa, Mitsuko
通讯作者：
Yuzawa, Mitsuko